Comparison of drop jump landing biomechanics and asymmetry among adolescents with hamstring, patellar and quadriceps tendon autografts for anterior cruciate ligament reconstruction

The Knee ◽  
2018 ◽  
Vol 25 (6) ◽  
pp. 1065-1073 ◽  
Author(s):  
Nicole M. Mueske ◽  
Curtis D. VandenBerg ◽  
J. Lee Pace ◽  
Mia J. Katzel ◽  
Tracy L. Zaslow ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Quadriceps Tendon ◽  
Drop Jump ◽  
Cruciate Ligament Reconstruction ◽  
Jump Landing ◽  
Landing Biomechanics ◽  
Anterior Cruciate

scholarly journals SEX, PATELLAR TENDON GRAFT, AND EARLY MOTION DEFICITS PREDICT ARTHROFIBROSIS AFTER PEDIATRIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0009
Author(s):  
Abraham J. Ouweleen ◽  
Tyler B. Hall ◽  
Craig J. Finlayson ◽  
Neeraj M. Patel
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Children And Adolescents ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Univariate Analysis ◽  
Quadriceps Tendon ◽  
Extension Deficit ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background: Arthrofibrosis remains a concerning early complication after anterior cruciate ligament reconstruction (ACLR) in children and adolescents. Previous studies suggest that those receiving patellar tendon (PT) autograft may be at higher risk than hamstrings tendon (HT), but there is little data regarding this complication in patients receiving quadriceps tendon (QT) autograft. Purpose: The purpose of this study is to identify risk factors for arthrofibrosis following pediatric ACLR with attention to graft type. Methods: The medical records of patients that underwent primary ACLR at a single tertiary children’s hospital were reviewed for this retrospective cohort study. Those with multiligament reconstructions, lateral extra-articular tenodesis procedures, or a modified MacIntosh reconstruction were excluded. Arthrofibrosis was defined as a deficit of 10 degrees of extension and/or 20 degrees of flexion at 3 months after ACLR. Demographic data, intra-operative findings and techniques, and post-operative motion and complications were recorded. Univariate analysis was followed by purposeful entry logistic regression to control for confounding factors. Results: A total of 378 patients were included in the analysis, of which there were 180 PT, 103 HT, and 95 QT grafts. The mean age was 15.9±1.7 years and 188 (49.7%) were female. In univariate analysis, the rate of arthrofibrosis was 1.9% for HT, 6.3% for QT, and 10.0% for PT (p=0.04). Females developed arthrofibrosis more frequently than males (10.6% vs. 3.2%, p=0.004). Additionally, those that ultimately experienced this complication had lower median flexion at 6 weeks after ACLR (88 vs. 110 degrees, p<0.001). After controlling for covariates in a multivariate model, PT graft raised the odds of arthrofibrosis 6.2 times compared to HT (95% CI 1.4-27.6, p=0.02), but there were no significant differences between QT and other graft types. Females were at 4.2 times higher odds than males (95% CI 1.6-10.8; p=0.003). Patients that were unable to attain 90 degrees of flexion 6 weeks after ACLR had 14.7 times higher odds of eventually developing arthrofibrosis (95% CI 5.4-39.8; p<0.001). Finally, those with an extension deficit of ≥5 degrees 6 weeks after ACLR had 4.7 times higher odds of experiencing this complication (95% CI 1.8-12.2, p=0.001). Conclusion: After adjusting for multiple covariates, PT autograft, female sex, and motion deficits at 6 weeks after ACLR (<90 degrees of flexion or extension deficit ≥5 degrees) were predictive of arthrofibrosis in children and adolescents. Quadriceps tendon autograft did not increase the risk of this complication.

scholarly journals Biomechanical Symmetry during Drop Jump Landing and Takeoff in Adolescent Athletes Following Recent Anterior Cruciate Ligament Reconstruction

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 639
Author(s):  
Eva M. Ciccodicola ◽  
Nicole M. Mueske ◽  
Mia J. Katzel ◽  
Curtis D. VandenBerg ◽  
James Lee Pace ◽  
...  
Keyword(s):  
Power Generation ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Jump Height ◽  
Drop Jump ◽  
Adolescent Athletes ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

This study investigated asymmetry between lower extremities during the landing and takeoff phases of a vertical drop jump (VDJ) in adolescent athletes following anterior cruciate ligament reconstruction (ACLR) and examined if performance was affected by reducing jump height. Thirty-three athletes who underwent ACLR and were referred for 3D biomechanical assessment before returning to play (mean age 15.9, SD 1.3 years; 16/33 female; mean time since surgery 7.4, SD 1.2 months) completed the VDJ while kinematics and kinetics were collected using motion capture. Lower extremity symmetry was compared between phases using paired t-tests. Jump height was calculated to measure performance. Asymmetries in ankle inversion, ankle adduction, knee adduction, hip adduction, hip adduction moment, and hip rotation moment were observed in both phases. Asymmetry was also observed in both phases for sagittal moments and power integrals at the knee and ankle and total power integral, with the magnitude of asymmetry being smaller during takeoff for power absorption/generation. Jump height was related to power generation integrals during takeoff but not to the asymmetry of power generation. Since asymmetries are translated from landing through takeoff, rehabilitation should address both phases to decrease injury risk and maximize performance after return to play.

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